title: The effect of perinatal exposures on the infant: antidepressants and depression.
abstract: Depression, anxiety, or both, during pregnancy are common complications during the perinatal period, with 15-20% of women experiencing depression at some point during their pregnancy. Considerable evidence suggests that untreated or undertreated maternal Axis I mood disorders can increase the risk for preterm birth, low birth weight, and alter neurobehavioral development in utero. Serotonin reuptake inhibitor antidepressants are often considered for antenatal therapy, with the goal of improving maternal mental health during pregnancy. Treatment with a serotonin-reuptake inhibitor, however, does not guarantee remission of depression, and in-utero serotonin reuptake inhibitor exposure has also been linked to increased risks for adverse infant outcomes. In this chapter, evidence linking serotonin reuptake inhibitor use with an increased risk for postnatal adaptation syndrome, congenital heart defects, and neonatal persistent pulmonary hypertension is reviewed. Management decisions should include attention to the continuum of depression symptoms, from subclinical to severe major depressive disorder and the long-term developmental risks that might also be associated with pre- and postnatal exposure.
authors.affiliation: Child and Family Research Institute, University of British Columbia, 948 West 28th Ave, Vancouver, BC V5Z 4H4, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. Electronic address: Gillian.Hanley@cw.bc.ca.
authors.forename: Gillian E
authors.initials: GE
authors.lastname: Hanley
authors.affiliation: Child and Family Research Institute, University of British Columbia, 948 West 28th Ave, Vancouver, BC V5Z 4H4, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada. Electronic address: toberlander@cw.bc.ca.
authors.forename: Tim F
authors.initials: TF
authors.lastname: Oberlander
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects*; D001007:Anxiety / Q000523:psychology; D002653:Child Behavior Disorders / Q000209:etiology; D003863:Depression / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005790:General Adaptation Syndrome / Q000139:chemically induced; D006330:Heart Defects, Congenital / Q000139:chemically induced; D006801:Humans; D007231:Infant, Newborn; D010547:Persistent Fetal Circulation Syndrome / Q000139:chemically induced; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000523:psychology; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000523:psychology; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: infant outcomes; prenatal maternal depression; serotonin reuptake inhibitors